Demonstrating a Nurse-Driven Model for Interprofessional Academic-Practice Partnerships

The World Health Organization (WHO) describes interprofessional practice (IPP) as "...multiple health workers from different professional backgrounds working] together with patients, families, caregivers, and communities to deliver the highest quality of care" (WHO. 2010. The WHO deemed that interprofessional education and practice (IPEP) is vital to attain a workforce that Is ready and able to care for local health needs through teamwork and collaboration (WHO. 201 Oh Interprofessional teams are critical in the care of acute, chronic, and complex health and social support needs of COVID-19 patients (Michalec & Lamb. 20201.1 PE and IPP are so essential to care that accreditation bodies have come together to provide guidance about how to embed these activities throughout all health professions programs (Health Professions Accreditors Collaborative. 2019). When delivered Intentionally, IPEP has the potential to achieve the Quadruple Aim (i.e., Improved quality, Increased population health, reduced costs, and improved clinician experience), with teamwork playing a large part In the achievement of the fourth aim: addressing the needs of healthcare workers, and reducing stressors experienced by the past, current, and future healthcare workforce, including nurses (Bachvnskv. 2020: Nurses have demonstrated that they are In an ideal position on the healthcare team to meet the additional demands placed on health services (e.g., contact tracing, testing, vaccine administration) and increased demand for staff, resources, policies, and supplies by the COVID-19 pandemic, all of which threaten an already overtaxed system (Diabv et al„ 2021).

Health profession students' outlooks on the medical profession during the COVID-19 pandemic: a global perspective.

BACKGROUND: This article summarizes a global study of the effect of the COVID-19 pandemic on junior health professions students' outlook on medicine. The pandemic has significantly affected health professions education. There is limited understanding of how students' pandemic experiences will affect them, and what impact these events may have on their career paths or the future of the professions. This information is important as it impacts the future of medicine. METHODS: In the Fall 2020 semester, 219 health professions students at 14 medical universities worldwide responded to the question: 'Has this experience (with COVID-19) changed your outlook on medicine as a profession?'. Short essay responses were semantically coded and organized into themes and subthemes using an inductive approach to thematic analysis. RESULTS: 145 responses were submitted. Themes were identified: (1) students reflected on the interaction between politics and healthcare; (2) reported becoming more aware of the societal expectations placed on healthcare professionals, including undertaking high risks and the sacrifices that healthcare professionals must make; (3) found reassurance from the recognized importance of healthcare professionals and expressed pride to be entering the profession; and (4) reflected on the current state of healthcare, including its limitations and future. CONCLUSION: Most students, independent of the extent of the pandemic in their respective countries, noted a change in their outlook regarding medicine. An overall positive outlook was noted in most junior students. Educators need to work on nurturing these sentiments and attitudes to help young students maintain a healthy relationship towards their chosen profession.

Seeing the Patient as a Person: Reflections from the Implementation of the Meet My Loved One Project (Sch459)

Outcomes: 1. Utilizing a discussion-based approach, participants will self-report the ability to inject humanism and dignity into patient care by utilizing and incorporating initiatives like the MMLO into their practice. 2. Evaluate and analyze the impact of initiatives such as the MMLO project on patients' families and on healthcare workers. Purpose(s): As COVID-19 surged, patients and healthcare workers (HCWs) experienced diminished recognition of patient personhood and increased burnout. Adapted from the University of Alabama's MMLO initiative, the UNC palliative care team implemented the MMLO initiative in the early stages of the COVID-19 pandemic to elicit personhood, restore patient dignity, and provide patient-centered care. The team also aimed to understand the MMLO's effect on HCWs and patient care. Method(s): Primary teams identified candidates and made referrals. The MMLO team called patients' loved ones to explain the initiative and ask questions from the MMLO form. Respondents' answers were posted at patients' bedsides along with collected patient photos. Survey data were collected from participants immediately prior to and 2-7 days after form completion. Quantitative and qualitative data from HCWs' experiences with MMLO were also collected after implementation. Result(s): Using a Mann-Whitney test, there is a significant improvement in median satisfactory level between the pre- and post-MMLO surveys of patients' loved ones regarding their perception of the care provided. Of the 21 HCWs surveyed, 96% agreed they learned something about their patients, and 58% stated they learned something about themselves after taking care of patients with a completed MMLO. Additionally, 90% of the HCWs stated that the MMLO increased their connectedness to their patients, and 76% stated that this project will positively change their future care of patients. Implications: The MMLO revealed the importance of connectedness and reflection. For HCWs, the connectedness to patients at a time of heightened stress reinforced a sense of purpose. Reflections concluded that the MMLO "visualized that people care" and provided a new lens for how others see the medical profession. Given these positive outcomes, we hope to universally implement the MMLO throughout the UNC Health Care system and promote it more broadly.Copyright © 2023

Semmelweis: his fight for hand hygiene

Clinicians today have never, perhaps, been more aware of the utmost importance of handwashing prior to clinical examination and surgery. However, in the 1800s this was not the case. The simple act of handwashing was once ridiculed and debated with considerable controversy within the medical profession. It was obstetrician Ignaz Semmelweis (1818-1865) who put forward its importance, and thereafter Joseph Lister who, in 1864, developed antiseptic techniques in surgery, following on from Pasteur and Koch's work on germ theory. In 1846, Dr Semmelweis was working in Vienna, responsible for the first division of maternity services. He noticed the striking difference in mortality rate in women who had deliveries by doctors and medical students, compared with deliveries by midwives. This mortality was known as puerperal fever or childbed fever. He hypothesized that doctors and medical students were transferring 'cadaverous particles' as they handled cadavers during autopsies, and then went on to examine pregnant women. The mortality rate was lower when midwives, who did not handle cadavers, performed deliveries. Thereafter, he initiated mandatory handwashing for all those delivering babies, using chloride of lime solution. The mortality rate reduced significantly after the implementation of handwashing and the washing of medical instruments. However, Semmelweis's hypothesis was not supported by many in the medical profession, and most senior academics questioned and disregarded his conclusions. He subsequently returned to Budapest where he continued to work and undertake handwashing. He published 'The etiology, concept, and prophylaxis of childbed fever' in 1861, but it was deemed a laborious read and was poorly received. Unfortunately, reports indicate that Semmelweis's behaviour and actions deteriorated, some speculated due to early-onset dementia or syphilis. He was admitted to a Viennese psychiatric hospital and died in 1865 aged 47 years. Ironically, given his passion for hygiene, he died from sepsis due to a wound infection. Semmelweis has been acknowledged with a university hospital and museum named after him, as well as a postage stamp, issued in Austria in 1965 on the 100th anniversary of his death. Many lessons have been learned from Semmelweis. The medical establishment was slow to adopt his advice. Handwashing effectively reduces healthcare-associated infections, and clinician adherence to hand hygiene advice has increased since the advent of the COVID-19 pandemic. The World Health Organization's 'My 5 moments for hand hygiene' is known worldwide, with its most recent caption (2021) 'Seconds save lives - clean your hands'.

Psychological burden of doctors aspiring for postgraduate training in India during COVID-19 Pandemic

Background: Doctors are under tremendous amount of stress during the COVID-19 pandemic. The uncertainty regarding future is compounded by lack of clarity about the postgraduate entrance exam. We assessed aspirants of postgraduate (PG) National Eligibility and Entrance Test (NEET) for psychological burden in domains of depression, anxiety, stress COVID related stress, attitudes towards situation affecting doctors and explored the association between psychological burden and other variables. Method(s): Google form was used to collect data from aspirants who appeared for NEET PG 2021 aspirants. The variables included age, gender, career status, marital status, number of attempts and medical environment related stress. Depression, Anxiety and Stress Scale (DASS 21) and COVID-19 Student Stress Scale Questionnaire (CSSQ) scales were used to measure psychological burden. Analysis was done using SPSS version 21.0. Result(s): of 289 participants, two-thirds had very severe depression and anxiety while two-fifths had very severe stress. Most of them were distressed with NEET exam, the postponed Supreme Court verdict, mental health of PG aspirants, and violence against healthcare workers. There is low satisfaction with having chosen medical profession. The distress from the above medical environment was associated with depression and anxiety. Gender and COVID related stress were associated with severe depression, anxiety and stress. Multivariate logistic regression showed female gender and CSSQ score were associated with risk of severe stress and happiness with medical profession was protective Conclusion(s): PG aspirants are undergoing severe psychological burden. Prompt action should be taken to address this crisis.

Goshpods: Paediatric Educational Podcast Series from Great Ormond Street Hospital

Background Podcasts are a popular way to engage people in education. Flexibility and ease of accessibility are some of the key advantages of this media. In this oral presentation we describe the process of recording and publishing paediatric educational podcasts across several different platforms including our assurance processes to ensure content is accurate and up to date. Methods Subject matter experts (SME) for the MRCPCH release of GOSHPODS are senior clinicians at GOSH. The titles for this series of podcasts was chosen by alignment with the MRCPCH syllabus. A second SME reviewed each podcast's content. Podcasts were released across a multitude of platforms including Soundcloud Spotify Apple and GOSH Digital Education Network. Results From October 2020 to May 2021 the total numbers of podcast plays and starts was 1,928 across 35 countries. An average of 241 plays per month. The top three countries were the United Kingdom United States of America and Malaysia. A female audience predominated at 60%. The most popular listener age range was across 28-34 year olds. Ethics and Neurology streams were the most popular content and the most popular platform was Spotify. Discussion We have demonstrated the wide reach of GOSHPODS across 35 countries as a means to communicate education with listeners during the COVID-19 pandemic. The continued increase in listeners indicates a growing desire for educational materials in this format. The female predominance of our audience aligns with the current female predominance in the medical professions. Conclusion GOSHPODS have further enabled the GOSH Learning Academy to disseminate education globally and to a diverse audience. The next steps in progressing this project are to gain additional feedback on releases so as to continue to grow our audience and measure the effect on confidence in knowledge and application to clinical practice.

Destroying Institutions: Abandoning the Medical Profession During a Pandemic

Institutions have been described as essential patterns of behavior that come to support a society and are generally understood and agreed upon in their roles. They can include behaviors that individuals must participate in as in rites of passage in religion, or in the use of money or joining a military or providing labor for communal structures or means as in irrigation. When one segment of a society comes to disagree with the goals of institutions and withdraws support or actively attacks one or more, it threatens not only the existence of the institution but the society as an organization. Often in history, revolutions are built on such attacks as in those of the Optimates in Ancient Rome or the Bolsheviks in Russia. The attack on the medical profession in the United States has been one that has a longer history, one bracketed in disbelief in science in general and has set the two institutions of religion and medicine at odds. An underfunded medical profession has faced the pandemic in a cloud of conspiracy theories that question even the purpose or need for medicine. The consequences during Covid-19 have been catastrophic by many assessments.

Evidence-based medicine and physicians' institutional agency in Russian clinical settings

In 1990s' Russia, a wave of internationalization brought an evidence-based medical paradigm to Russian healthcare. Whilst there has been considerable critical commentary on the consequences of adopting this paradigm for medical decision-making, much of this relates to specific contexts in Europe, north America and Australasia, with little research addressing post-Soviet clinical practice. Drawing on semi-structured qualitative interviews with Russian physicians, this article explores the entanglements between the introduction of evidence-based medicine (EBM) in the country and the transformation of post-socialist medical professionalism. I single out physicians' efforts to reconcile the EBM paradigm with organizational constraints as indicative of professionals' ground-level agency. I define the following components of such agency: (1) selective application of guidelines and use of foreign clinical recommendations;(2) establishing local professional solidarity;(3) developing relationships based on personalized trust with the patients. The study employs two sets of data (gathered in 2018 and in 2020) to trace the EBM-related agency of medical professionals both before and during COVID-19 pandemic. By offering analytical insights from post-socialist healthcare, where doctors' discretion has historically been limited by excessive state control, the article contributes to academic debate on medical professionals' autonomy and agency in the era of EBM-related standardization.Copyright © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Psychological Impact on Healthcare Workers of Past SARS and Current COVID-19 Outbreak: A Global Review

The emergence of novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in Wuhan, China during late 2019 spread quickly and creating international emergency and tremendous challenges for healthcare workers (HCWs) including dental and oral healthcare professionals. The brisk spread of this new viral disease forced HCWs to suffer from different types of stress including mortality and morbidity, delayed patient dealing, scarcity of complete personal protective equipment (PPE), and fear of being COVID-19 virus target and carriers to their family members. The dental and oral HCWs were also advised to apply mobility restrictions and social distancing measures. All of a sudden, most of the regular medical check-ups including dental clinic appointments were cancelled, reducing the number of patients flow. The abrupt cancellation of appointments put a sudden break on medical profession including dental practice. Different scales like progression of post-traumatic stress disorder (PTSD), Chinese Health Questionnaire-12 (CHd-12), Davidson Trauma Scale-Chinese (DTS-C), General Health Questionnaire (GHQ), Impact of Event Scale (IES), Perceived Stress Scale (PSS) etc. have been devised in different countries to assess the overall mental health status. The reports from earlier SARS outbreak in 2007 had also put a psychological impact on HCWs but least has been learned from this out break. The reports from previous Middle East respiratory syndrome (MERS) outbreaks and early COVID-19 pandemic have a considerable negative impact (short and long-term) on mental status of HCWs. Different types of negative impacts on mental health like depression, anxiety, sleep disorders and distress were reported in HCWs during COVID-19 pandemic. The current COVID-19 pandemic given a broader understanding of how much, how far and how fast an outbreak can occur and affect HCWs psychologically. In this review, authors summarize the impact of COVID-19 pandemic in the psychology of HCWs, as reported from different countries.Copyright © 2022, Anka Publishers. All rights reserved.

Emerging Technologies For Diabetes Management: Application And Challenges

For the last few years, technology has had its impact in laboratory affairs, and this has been given an urgent impetus by the COVID-19 pandemic. As a general rule, laboratories have become 'smarter'. The 'intelligent' lab today uses more of automation, software, artificial intelligence, and changes are grossly evident at the manufacturer level. Flexibility is the key for Industry 4.0 (and Lab 4.0) and the faster one adapts, better will be the ability to survive in the global market. Technological developments are an essential part of medical profession in research and patient care. The development of technologies goes hand-in-hand with improvement in healthcare delivery standards. However, technological developments have also met with significant challenges. Many of the advances in the recent years have not found a role in actual clinical care, even today. For example, continuous subcutaneous insulin infusion (CSII) pump and continuous glucose monitoring ( CG M) devices offered a lot of promise in the management of Type I Diabetes Mellitus, especially in young patients;however, they have found limited actual clinical utility. Similarly, many novel computational tools have also come up in the self-management of diabetes mellitus. These include, but are not limited to wearables ' sensors and apps. Practical issues, health-economic challenges, and ethics need to be considered before emerging technologies find a place in routine use.

Engaging Vaccine Hesitant Patients: An Ethics Approach

Vaccine hesitancy has been presented as a great obstacle to the "end of COVID." The large groups of protestors and low compliance have created tensions between groups of individuals. Healthcare providers have expressed anger and frustration to have unvaccinated individuals arrive at the emergency department in deteriorating conditions when these severe conditions could have been prevented. However, patient-centered care advocates that the patient's voice and values are acknowledged. Vaccine hesitancy, vaccine defiance, and mistrust of the medical profession have been continuous and recurrent phenomena. There are many instances in which medical research and technology occurred at the exploitation of marginalized groups. The Tuskegee Syphilis experiment is well known but others have been obscured. Indeed, ethicists acknowledge that moral objections to questionable research methods can be overturned in cases of emergency. Patients do have their own reasons why they may be vaccine hesitant despite acknowledging that vaccination is necessary. This presentation will present an ethics methodology approach to encourage collaboration between opposing groups. Reasons for both vaccine hesitancy and vaccine support will be presented. The goal is to provide respiratory students and professionals with additional tools to approach vaccine-hesitant patients so that future confrontations are collaborative and proactive. Recommended methods on how to approach and challenging patients on their values can help guide difficult discussions around vaccinations and mistrust in healthcare.

Practical and Ethical Considerations in Telehealth: Pitfalls and Opportunities

Telehealth has been a long-awaited advancement with the potential to improve efficiency, convenience, and quality in healthcare. However, as telehealth becomes integrated into routine clinical care, it is imperative to consider the practical and ethical implications that could undermine or devalue care delivery. The medical profession must ensure that it is implemented judiciously and with robust quality standards, guided by fair and equitable policies that balance patient autonomy with rigorous standards of care and access. Such a system must recognize the opportunity for more patient input as stakeholders to tailor care to their needs and preferences, while also acknowledging the risk of suboptimal care if convenience is prioritized over quality. More studies of optimal care models are needed to integrate data in terms of both stakeholder input and outcomes.

Mitigating an Infodemic: Can The Professions Still Regulate Themselves?

[...]the World Health Organization (WHO) defines infodemic as "too much information including false or misleading information in digital and physical environments during a disease outbreak. While there are several resources with statistics related to mortality and morbidity, various issues, such as a lack of testing, raise questions about the reliability of these numbers. Dr. Paul is licensed in Kentucky and Dr. Oz is licensed in New York. Because of their notoriety, their comments are reported across many of the better-known news organizations. [...]the following quote is taken from the Mission Statement on the web site: "We The People with independent information from the world's top experts in medicine and law, so you can be empowered with facts, protect your health, and .."

COVID-19 Pandemic Effect on Psychological Status and Perception towards the Medical Profession among Haryana’s First Year MBBS Students: A Cross-sectional Study

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has emerged as a major health crisis throughout the world. In order to control the spread of disease in India, the Central Government imposed a nationwide lockdown. The ongoing spread of the pandemic, strict lockdown measures and delay in the opening of educational institutions in the country are expected to affect the mental health of medical college students too. In order to help and guide the students, we should first be aware of the magnitude of the problem faced by medical students due to the pandemic. For this purpose, this study was conducted online. Aim: To assess the effect of the pandemic on the psychological status of the students and their perception towards medical profession. Materials and Methods: A cross-sectional study was conducted by the Department of Biochemistry of Kalpana Chawla Government Medical College, Haryana, India from 22nd May 2020 to 5th June 2020, among 538 first year Bachelor of Medicine, Bachelor of Surgery (MBBS) students from several Government and Government aided medical schools in the state of Haryana after obtaining ethical clearance. The detailed questionnaire, a study consisting of sections on the current status in relation to the COVID-19 pandemic, perception towards medical profession and psychological status. It was posted online on social media platforms and the responses were collected within 15 days of posting. The psychological status was assessed based on a 21 item Depression, Anxiety, and Stress Scale (DASS-21). Statistical analysis was done by Chi-square test, using Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: Out of 538 student’s responses, it shows that 19.1% (n=103) of students experienced moderate stress, probably because of the COVID-19 outbreak and the effect it had on the social and academic aspects of their lives. About 11.5% (n=62) of students had a moderate level of anxiety, and 16.9% (n=91) had experienced moderate depression during the ongoing pandemic. Conclusion: The study demonstrates various factors, like interruptions in regular studies, social distancing, fear of infection, fear of losing a loved one, and worry about the completion of the syllabus and examinations, all cause stress and anxiety in students.

A Survey on Lung Disease Diagnosis using Machine Learning Techniques

Respiratory diseases are among the most severe diseases in the world. With the outbreak in 2020, the mortality rate among people affected by respiratory diseases has gone up by a significant amount. Early detection of these diseases could help the patients to be able to receive treatment and cure the disease at an earlier stage. Existing manual diagnoses methods take up a significant amount of time for the results to be obtained. The use of Machine Learning techniques in the medical profession has been made possible by recent developments in the disciplines of Image classification and Deep learning, as well as the availability of numerous open-source datasets. Machine learning models used in diagnoses of lung diseases have decreased the time needed for detection and reduced the amount of manual work required. This research examines how various machine learning algorithms can be used to diagnose various lung conditions. The key goal of this paper is to visualize the various trends in lung disease diagnoses using machine learning and recognize the existing issues and the in this domain's possible future. The potential future in this domain can be explored by increasing the accuracy of existing systems and increasing the number of lung diseases detection applications that are aided by machine learning. © 2022 IEEE.

“The Patient Decision Aid as a Pedagogical Tool: Exigencies between RHM and the Health Professions”

This past decade, the healthcare industry has undergone a transformation with where, how, and why writing happens. For example, what the health and medical professions conceive of as “documentation” or “charting” is writing, even though practitioners call it by another name. Additionally, most writing in healthcare settings is now also multimodal, incorporating textual, digital, visual, and aural content. This essay focuses on the patient decision aid as pedagogical tool that embraces the technological and multimodal changes in health and medicine. Patient decision aids can be understood as a multimodal tool guiding shared decision-making practices. As a genre, the decision aid prompts students to engage in a series of writing modalities – visuals, narrative, texts – as well as the application of user experience and design. Finally, the decision aid as an assignment offers explicit connections between humanities-based students and broader healthcare industries.

A MobileNet-V2 COVID-19: Multi-class Classification of the COVID-19 by Using CT/CXR Images

COVID-19 is one of the most dangerous virus that has been separated among the entire world. At the beginning stage of COVID-19 virus, the RT-PCR is the only testing method to detect the virus. Later, the medical professions analyze the different medical scanning approaches for the detecting of COVID-19. The computer tomography (CT) and chest X-ray (CXR) images are well-suited for detecting the virus. In image processing algorithms, there is lots of deep learning (DL) algorithms are employed for identifying the diseases which are affected in the human body. Hence, the paper presents the deep learning approach of COVID-19 detection by using the CT/CXR medical images. Here, the pre-trained MobileNetV2 is fully loaded with training dataset of COVID-19 images. Initially, the testing medical images are preprocessed by DnCNN algorithm to get the residual image of the corresponding medical image and forwarded to the feature extraction unit, and finally, the classifier finds the COVID-19, non-COVID-19, and pneumonia from the testing dataset. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Hygiene in Dermatology: SARS-CoV-2 and Variants of Concern

Around the world the COVID-19 pandemic has severely impaired life and work. With the beginning of vaccinations, the hope of a turnaround increases. Nevertheless, COVID and intensive care units in hospitals are still heavily burdened. Often, for capacity reasons, medical dermatological as well as dermatological nursing specialists are involved in treatment and care of COVID-19 patients in clinics. As a result dermatological manifestations of COVID-19 could be recognized and classified more closely in the course of the pandemic. However, differentiated hygiene concepts, especially that of hand hygiene, reveal another dermatological problem associated with the pandemic: the development of hand eczema. This is not limited to medical professions and therefore shows a possible overriding importance of dermatology in the context of future pandemic strategies.